Role of sleep duration and quality in the risk and severity of type 2 diabetes mellitus
Role of sleep duration and quality in the risk and severity of type 2 diabetes mellitus
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DOI：
10.1001/archinte.166.16.1768
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发表时间：
2006-09-18
影响因子：
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通讯作者：
Van Cauter, Eve
中科院分区：
文献类型：
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作者：
Knutson, Kristen L.;Ryden, Armand M.;Van Cauter, Eve
背景：来自实验室和流行病学研究的证据表明，睡眠时长减少或质量下降可能会增加患糖尿病的风险。我们研究了睡眠不足或睡眠质量差是否与非裔美国2型糖尿病患者的血糖控制有关。
方法：我们对在伊利诺伊州芝加哥大学医院接受访谈的2型糖尿病志愿者进行了一项横断面研究。最终分析纳入了161名参与者。通过病历中的糖化血红蛋白（HbA₁c）水平来评估血糖控制情况。使用匹兹堡睡眠质量指数（PSQI）评估睡眠质量。感知睡眠负债计算为理想的平日睡眠时间与实际平日睡眠时间的差值。
结果：平均±标准差睡眠时间为6.0±1.6小时，71%的参与者被归类为睡眠质量差（PSQI评分>5）。我们排除了因疼痛经常睡眠中断的患者（n = 39）。在无糖尿病并发症的患者中，血糖控制与感知睡眠负债有关，但与PSQI评分无关。每晚感知睡眠负债为3小时时，预测的HbA₁c水平升高比中位数高1.1%。在至少有1种并发症的患者中，HbA₁c水平与PSQI评分有关，但与感知睡眠负债无关。PSQI评分增加5分，预测的HbA₁c水平升高比中位数高1.9%。
结论：在我们的样本中，睡眠时间和质量是HbA₁c（血糖控制的一个关键指标）的重要预测因素。结合现有的将睡眠不足与糖尿病风险增加相关联的证据，这些数据表明，优化睡眠时间和质量应作为一种干预措施进行测试，以改善2型糖尿病患者的血糖控制。
Background: Evidence from laboratory and epidemiologic studies suggests that decreased sleep duration or quality may increase diabetes risk. We examined whether short or poor sleep is associated with glycemic control in African Americans with type 2 diabetes mellitus.Methods: We conducted a cross-sectional study of volunteers with type 2 diabetes interviewed at the University of Chicago Hospitals, Chicago, Ill. The final analysis included 161 participants. Glycemic control was assessed by hemoglobin A(1c) (HbA(1c)) level obtained from medical charts. Sleep quality was assessed using the Pittsburgh Sleep Quality Index ( PSQI). Perceived sleep debt was calculated as the difference between preferred and actual weekday sleep duration.Results: The mean +/- SD sleep duration was 6.0 +/- 1.6 hours, and 71% of the participants were classified as having poor quality sleep ( PSQI score > 5). We excluded patients with sleep frequently disrupted by pain ( n = 39). In patients without diabetic complications, glycemic control was associated with perceived sleep debt but not PSQI score. The predicted increase in HbA1c level for a perceived sleep debt of 3 hours per night was 1.1% above the median. In patients with at least 1 complication, HbA(1c) level was associated with PSQI score but not perceived sleep debt. The predicted increase in HbA(1c) level for a 5-point increase in PSQI was 1.9% above the median.Conclusions: In our sample, sleep duration and quality were significant predictors of HbA(1c), a key marker of glycemic control. Combined with existing evidence linking sleep loss to increased diabetes risk, these data suggest that optimizing sleep duration and quality should be tested as an intervention to improve glucose control in patients with type 2 diabetes.